Objective(s): In a review of our series from 2007 we noted a high incidence of junctional or low atrial rhythm when using a two-patch technique for sinus venosus atrial septal defects (SVASD). Because of this, over the last 15 years our surgical strategy has avoided two-patch repairs and we have used either one-patch repairs or the Warden procedure.Methods: Between 1990 - 2018, 144 patients underwent repair of SVASD at our institution. Median age was 4.4 years. Partial anomalous pulmonary venous connection (PAPVC) was present in 135 patients (94%). A single autologous pericardial patch placed through a right atrial incision was used for 114 patients (79%), a two-patch technique in 23 patients (16%), and a Warden procedure in 10 patients (7%).Results: Median length of stay was 4 days. Since 2010 low atrial or junctional rhythm requiring temporary pacing occurred in 2 of 63 patients (3%). This compared to 12 of 22 patients (55%) with low atrial or junctional rhythm after the two-patch repair in our prior review (p<0.001). On echocardiogram follow-up no patient had pulmonary vein stenosis. Three patients had very mild superior caval vein narrowing and one Warden patient required a superior caval vein stent 3 years postoperatively.Conclusions: The great majority of patients with SVASD and PAPVC can be successfully repaired with a single patch of autologous pericardium. We transitioned in the year 2001 to using either a single pericardial patch or the Warden procedure with improved maintenance of normal sinus rhythm.